Evolution of the incidence of tuberculosis in the iII health area of the Principado of Asturias, Spain

Aim: Description of the evolution of the incidence of tuberculosis (TB) in the last 10 years and the different circumstances that can have influence on it. Methods: We collected all the cases of cultured proven TB. We describe factors that can have influence: 1. Number of immigrants, HIV co-infection, immunosuppression (biological therapy included). 2. Molecular epidemiology. 3. Treatment follow-up. 4. Contacts study. Results: Our Health Area has 155, 000 inhabitants and we had 388 TB patients in 10 years,with a global incidence of 25/100,000 population per year (15/100,000 last year). 1. The percentage of immigrants, HIV co-infection and immunosuppression is small (figure 1). 2. The molecular study performed in 50 patients (2008-2010) shows clustering in 74%. 3. We had 89% of patients treated with successful results (cure or treatment completion). 4. We had performed contacts study during all the period but we only know data since 2008 when we started a Pilot Programme (we studied 398 contacts from 82 patients, with 128 infected contacts with preventive therapy). Conclusions: We had a continuous decrease in the incidence of TB, mainly in the last year, with a small percentage of immigrants, HIV co-infection and immunossupresive therapy, good therapy compliment, and a Programme of study of contacts in a region with recent TB transmission. All together can explain the decrease of TB incidence.